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Date_ .a/ /mob Application No. <br /> Subdivision_� �9 Loi / ✓ �� " tom' /l,c,�l �_{7` g�_ / �/�sccT��i/e <br /> The following item(s) (does, does not) conform with the requirements of the <br /> Burnett County Subdivision Regulations. Those items not conforming are <br /> explained on the attached page. <br /> Does Does Not Not Applicable <br /> 1• i Submitted within 12 months of preliminary <br /> approval <br /> 2• Conforms to preliminary plat and incorporates <br /> suggested changes ., <br /> 3• Name of subdivision <br /> 4• �G P'toper scale <br /> 5. v' Date and North Point <br /> 6• Locational Description <br /> 7• Name and address of owner, surveyor and <br /> engineer <br /> B• v Accurate survey data-seconds; lineal dimensions <br /> to hundreths of feet; radiii; internal angles; <br /> points of curvature; tangent bearing; lengths of <br /> arcs; lengths of cords. <br /> 9• _!�" Bearings and distances to permanent monuments <br /> 10. v Name, location, width, and centerline of streets <br /> 11. L Lot' numbers and dimensions <br /> . 12• ✓ Location and description of monuments <br /> 13. _ Building setback lines <br /> 14. _ L Parks and open space and <br /> P p proper dedications <br /> 15. _ Final improvement plans <br /> 16. Installation or guarantee of installation of <br /> improvements <br /> 17• �- Required final certifications <br /> Signature <br /> Title/Position <br />